Ozzy Doing New GC Today - Appreciate any Feedback. Thanks!

Status
Not open for further replies.
Ozzy Pawzbourne

Ozzy Pawzbourne

Member Since 2016
Ozzy is doing a new BG curve today. We are +4.5 hours in so a little close to half way there. Appreciate any feedback you guys might have. His SS is in my signature.

I am curious if we should increase his dose. He has been on 1 U for about 5-7 days. He still has high preshot numbers and doesn't come down too low during his nadirs in the evenings but looks better during his afternoon nadirs.
I am off for the next 18 days so I can do more curves to get more data. I am thinking of taking him up to 1.25 tomorrow morning and curving him again.

Curious what you guys think. He is on vestulin.

BTW...he has been doing ABSOLUTELY FABULOUS!! He feels good, you can just tell, and has been very happy and super playful. I am so happy to see my sweetest little kitty feeling back to his happy little funny self.

I have been testing for ketones and they continue to be negative. His appetite has really picked up, he LOVES his new food, and he's back to trying to beat up his brother Fig. All in all- things are good over here in Southern California.

Just need to get him on the right dose of insulin and see those numbers normalizing. :)

I emailed my hospital vet his curve numbers from Monday and haven't heard a word back from him yet (5 days later) even though I've called twice and left messages. What would I do without you guys/gals? I LOVE the instant feedback. It's GREAT! THANK YOU!!!
 
Ozzy Pawzbourne said:
Ozzy is doing a new BG curve today. We are +4.5 hours in so a little close to half way there. Appreciate any feedback you guys might have. His SS is in my signature.

I am curious if we should increase his dose. He has been on 1 U for about 5-7 days. He still has high preshot numbers and doesn't come down too low during his nadirs in the evenings but looks better during his afternoon nadirs.
I am off for the next 18 days so I can do more curves to get more data. I am thinking of taking him up to 1.25 tomorrow morning and curving him again.

Curious what you guys think. He is on vestulin.

BTW...he has been doing ABSOLUTELY FABULOUS!! He feels good, you can just tell, and has been very happy and super playful. I am so happy to see my sweetest little kitty feeling back to his happy little funny self.

I have been testing for ketones and they continue to be negative. His appetite has really picked up, he LOVES his new food, and he's back to trying to beat up his brother Fig. All in all- things are good over here in Southern California.

Just need to get him on the right dose of insulin and see those numbers normalizing. :)

I emailed my hospital vet his curve numbers from Monday and haven't heard a word back from him yet (5 days later) even though I've called twice and left messages. What would I do without you guys/gals? I LOVE the instant feedback. It's GREAT! THANK YOU!!!
Click to expand...
You could try 1.25 u (maybe skinny it up by letting out a tiny drop) tomorrow and monitor. That dose caused a dramatic drop by +4 on 12/11. You can try giving a little snack of his regular food around +1.5 to see if you can keep him from dropping too fast.
 
Kris & Teasel said:
That dose caused a dramatic drop by +4 on 12/11.
Click to expand...
Yes, it did.

I'm confused with the vestulin. I know it causes quick drops and sometimes low drops. Seems like for Ozzy it drops him down around +2 to +4 hours and then he's just high the rest of the time. That's not what we want to see, right? Don't I want to see him mostly in green and blues when he is regulated and then in the yellows pre-shots? How do I get him there with Vestulin? Is this something that just takes time and he will eventually adjust down to lower numbers, or is he just flat out not agreeing with and/or on the wrong insulin?
 
I'm trying to be patient, but I don't think I really see any improvements yet. Do you guys?? When should I?
 
Last edited:
Ozzy Pawzbourne said:
Yes, it did.

I'm confused with the vestulin. I know it causes quick drops and sometimes low drops. Seems like for Ozzy it drops him down around +2 to +4 hours and then he's just high the rest of the time. That's not what we want to see, right? Don't I want to see him mostly in green and blues when he is regulated and then in the yellows pre-shots? How do I get him there with Vestulin? Is this something that just takes time and he will eventually adjust down to lower numbers, or is he just flat out not agreeing with and/or on the wrong insulin?
Click to expand...
Hi Momma of Ozzy...just a note to let u know u r not alone with this vetsulin question. Elmo has been on it since July and seemed to be doing ok but lately we r going smaller and smaller in doses ...beginning to beteer understand the whole "sugar dance" thing:). Thank goodness for all the awesome kitty parents who have gone before us on this board !!!
 
Ozzy Pawzbourne said:
he has been doing ABSOLUTELY FABULOUS!! He feels good, you can just tell, and has been very happy and super playful. I am so happy to see my sweetest little kitty feeling back to his happy little funny self.
Click to expand...
This is wonderful news, Joanna! :cat:


Kris & Teasel said:
That dose caused a dramatic drop by +4 on 12/11. You can try giving a little snack of his regular food around +1.5 to see if you can keep him from dropping too fast.
Click to expand...
I've had similar thoughts to yours, Kris, but I'd suggest giving a mini meal at +1.5 if there has been a significant drop (or +2 if the dose onset proves to be a bit later).

Needless to say it would be of critical importance to test to make sure that the 1.25 skinnied doesn't take Ozzy the Pawsome into too low a range at nadir - on both AM and PM cycles.


Mogs
.
 
Ozzy Pawzbourne said:
'm confused with the vestulin. I know it causes quick drops and sometimes low drops. Seems like for Ozzy it drops him down around +2 to +4 hours and then he's just high the rest of the time. That's not what we want to see, right?
Click to expand...
Correct.

While some cats do well on Vetsulin, because of the nature of the insulin itself a dose typically doesn't last long enough in cats because of their high metabolic rate. (Vetsulin, known as Caninsulin in the UK, tends to be a more effective treatment for canine diabetics; the clue's in the name.)

The response you're seeing is a fairly textbook one for Vetsulin (a cup-shaped curve with the dose running out of steam about 2/3 of the way through the cycle).

There are other in-out insulins which may provide longer dose duration than Vetsulin in cats (e.g. Prozinc, PZI) but numbers may rise quite significantly at the end of the cycle with these insulins, too.

With successive doses, the depot insulins Lantus and Levemir build up a store of insulin in the cat's body and therefore provide a more continuous glucose-lowering effect. On average Lantus and Levemir curves are flatter than those for in-out insulins. For example if a model Vetsulin curve is a cup then a model Lantus curve would be a saucer.

Ozzy Pawzbourne said:
I'm trying to be patient, but I don't think I really see any improvements yet.
Click to expand...
Regulation is a gradual process because the kitty's body needs to get used to running at lower, healthier BG levels and that takes time (and sometimes an insulin change, depending on how the cat responds to the initial treatment).

Unfortunately it's not a simple 'X amount of insulin results in an average BG level of Y' because the body's defence systems work to raise BG levels if a dose is too high, sometimes when a drop is too steep, or even when a cat has a smooth drop to a nadir in a perfectly safe - and not necessarily low - nadir range which the body hasn't seen for some time.

Alas! Patience is most definitely a pre-requisite. ;)


Mogs
.
 
Last edited:
Critter Mom said:
While some cats do well on Vetsulin, because of the nature of the insulin itself a dose typically doesn't last long in cats because of their high metabolic rate.
Click to expand...

Mogs, if you were me...what would you do? Stay on the vestulin for longer and see what happens, or suggest a switch from my vet? I know you have mentioned you struggled with Vestulin, too with your Saoirse and then switched her to Lantus.

Someone on this board mentioned or referenced a study (not sure if it was you) about Vestulin and that it's harder to get a cat into remission on this type of insulin. This is definitely our goal (remission) if possible. I also read somewhere that the treatment in the first few weeks/months was the most crucial in trying to get a cat into remission if it was going to happen. I think it had something to do with not letting them run high for a long time and long term beta cell damage. ??? If this is truly the case, I don't want to waste time with Ozzy being on the wrong insulin type or the wrong dose. I have 3 weeks off and want to try to see if I can get him better regulated while I am off work and can monitor him at home. BTW..I'm not expecting him to go into remission in 3 weeks, I am not even sure if it is possible. Our vet said it's less likely with a cat that has gone into DKA. I'm just saying I want to see if we can get him better regulated in the next few weeks if possible while I am at home and can monitor him. I don't know if this is realistic. Is it??

I also have been following Beth's threads about micro-dosing her Elmo with Vestulin as he's been throwing a lot of lower numbers lately and looking like he might go into remission. Fingers crossed for you Elmo buddy! But I see Beth has had a few scares with hypo even with the lower doses and has had to monitor (and intervene a couple times) to make sure her kitty was safe. I cannot do this unless it's on the weekends. I work every day about 20 miles away from my home (an hour with Los Angeles traffic). I am concerned I will never be able to bring Ozzy down or tightly control him on vestulin and the micro doses situation when/if he gets into the blues regularly just scares me down right.

I guess my misunderstanding about the gradual process is this: Should I expect to see him come down in time with the exact same dose? As in, it just takes time and it will lower on its own without an increase of insulin? Or - I need to slowly increase his dose and monitor him safely and then his numbers will come down due to the higher dose and then once he starts coming down, we reduce his dose again...and again, until his pancreas and liver are able to regulate on its own? What does the process cycle normally look like?

Also, what do you think about the Novolin insulin?
 
Last edited:
Ozzy is +10 hrs into his GC today.

Here are his curve results so far (you can also check out his SS):

AMPS: 388
+2: 249
+4: 196
+6: 240
+8: 271
+10: 307
+11: 312 (only went up 5 points in hour after eating about 1.5 oz of tuna hour ago)

He had a good drop around +4 but looked pretty steady on his rise thorough the rest of this cycle even though his numbers are still high. What should I make of this?

He ate really great this morning Probably the most in one feeding so far which was encouraging. He also ate 1.5 oz at 5pm and then when I put down more food for him at 7pm he didn't want it. This was the first time he refused food since he started eating good about a week ago. I was really discouraged. Maybe he was full; he did eat really good today. But I have to give him some insulin soon so I pulled out some tuna and he ate that and half of Fig's- about 1.5 oz. So I will give him his insulin here shortly.

Appreciate any feedback on his curve results. Also, I posted several questions above to a response to Mogs. Appreciate others feedback on these questions as well.

I tested him for ketones again tonight. I seriously can't believe he will just pee right on the strip for me! Small victories- right?! With everything else being so difficult, it's so nice that this part has been pretty easy! On the other hand- I swear his strips keep looking between negative and trace. I will keep monitoring just in case. I was told as long as he doesn't go over trace, we are good and he doesn't need to go to vets. I put more water in his food tonight. Wondering with this, and especially after his curve results, if we should go ahead and take him up to 1.25 minus a drop as Kris suggested above. He's going to get 1 U tonight because I've poked him enough times today and don't want to curve him again tonight when I may do it again tomorrow with a slightly higher dose.

Thanks all!

BTW.. I bought 2 petsafe5 feeders today (one for Oz one for Fig) that will arrive tomorrow. Looking forward to trying them out!
 
Last edited:
Ozzy Pawzbourne said:
BTW.. I bought 2 petsafe5 feeders today (one for Oz one for Fig) that will arrive tomorrow. Looking forward to trying them out!
Click to expand...
Did you order batteries? (I forgot to do so when I bought my first Petsafe 5. :oops: :rolleyes:)

Will post later to answer some of your questions, Joanna, but for now regarding your question about choice of insulin if I were in your shoes I'd be inclined to stick with Ozzy's current insulin for the time being (assuming he keeps responding well and is safe on it). The reason I'd want to do this would be to keep things as consistent and stable as possible to ensure he is well-recovered from the DKA episode. (It does take a lot out of a kitty.)

Later!

:bighug:


Mogs
.
 
Here's a tip on the feeders. Use rechargeable batteries. Change them out on a regular basis (I changed them the day Smokey got his flea spot treatment). One night his feeders didn't open (regular batteries) thank goodness it wasn't a night he went low, but because he didn't eat there was a lot of foamy spit up around the house.

We use rechargeable for everything in our house, so some are always charging.
 
Gave 1.25u minus 1 drop this am. Will test again today.

Here is a pic of Ozzy's am ketone test. Which result do you see? Negative or trace?
 

Attachments

  • 20161217_084724.jpg
    20161217_084724.jpg
    60.4 KB · Views: 49
Ozzy Pawzbourne said:
Ozzy is doing a new BG curve today. We are +4.5 hours in so a little close to half way there. Appreciate any feedback you guys might have. His SS is in my signature.

I am curious if we should increase his dose. He has been on 1 U for about 5-7 days. He still has high preshot numbers and doesn't come down too low during his nadirs in the evenings but looks better during his afternoon nadirs.
I am off for the next 18 days so I can do more curves to get more data. I am thinking of taking him up to 1.25 tomorrow morning and curving him again.

Curious what you guys think. He is on vestulin.

BTW...he has been doing ABSOLUTELY FABULOUS!! He feels good, you can just tell, and has been very happy and super playful. I am so happy to see my sweetest little kitty feeling back to his happy little funny self.

I have been testing for ketones and they continue to be negative. His appetite has really picked up, he LOVES his new food, and he's back to trying to beat up his brother Fig. All in all- things are good over here in Southern California.

Just need to get him on the right dose of insulin and see those numbers normalizing. :)

I emailed my hospital vet his curve numbers from Monday and haven't heard a word back from him yet (5 days later) even though I've called twice and left messages. What would I do without you guys/gals? I LOVE the instant feedback. It's GREAT! THANK YOU!!!
Click to expand...
The big drop is typical of Vetsulin in many cats. It hits fast and hard so there can be quite a dip up to +3 - +4 and then a rise back up to high numbers by +8 or so because it often doesn't last 12 hours. If this is the way it acts in Ozzy there's not a lot you can do dose-wise to the lower the PSs while preventing him from dropping too low.. You can "steer" with food if you're home to do that. Starting small snacks at +1.5 or so can help to head him off from the cliff.

If this issue continues you can ask you vet about a slower onset, gentler insulin. One that acts more like Vetsulin but not so aggressively is ProZinc. Then there are the depot insulins like Lantus and Levemir that have a different mode of action that can help a kitty to have a gentler drop and more duration. You have options.
 
Ozzy Pawzbourne said:
Someone on this board mentioned or referenced a study (not sure if it was you) about Vestulin and that it's harder to get a cat into remission on this type of insulin. This is definitely our goal (remission) if possible. I also read somewhere that the treatment in the first few weeks/months was the most crucial in trying to get a cat into remission if it was going to happen. I think it had something to do with not letting them run high for a long time and long term beta cell damage. ??? If this is truly the case, I don't want to waste time with Ozzy being on the wrong insulin type or the wrong dose. I have 3 weeks off and want to try to see if I can get him better regulated while I am off work and can monitor him at home. BTW..I'm not expecting him to go into remission in 3 weeks, I am not even sure if it is possible. Our vet said it's less likely with a cat that has gone into DKA. I'm just saying I want to see if we can get him better regulated in the next few weeks if possible while I am at home and can monitor him. I don't know if this is realistic. Is it??

I guess my misunderstanding about the gradual process is this: Should I expect to see him come down in time with the exact same dose? As in, it just takes time and it will lower on its own without an increase of insulin? Or - I need to slowly increase his dose and monitor him safely and then his numbers will come down due to the higher dose and then once he starts coming down, we reduce his dose again...and again, until his pancreas and liver are able to regulate on its own? What does the process cycle normally look like?

Also, what do you think about the Novolin insulin?
Click to expand...


Thanks so much Kris for your comments. Yes, that is exactly how it reacts in Ozzy. Is it possible then to achieve tight regulation on vestulin if Ozzy acts this way? Is it just too soon to tell? I see people saying on this board to try 6 cycles and then try to go up a little. He is well beyond 6 cycles on 1 u.

I am curious what you think about my questions quoted above??

Thank you!!!!
 
Critter Mom said:
I think I've provided the feedback you were looking for in my post on your latest thread.
Click to expand...
Yes, thank you!!!

Do you think kitties can go into remission on vestulin? I read on one of your other posts- you posted some research from a Rand Roomp or something or other study and it mentioned remission is more likely on the tight regulation protocol. Remission is what we want if it's possible.
 
Ozzy Pawzbourne said:
I see people saying on this board to try 6 cycles and then try to go up a little.
Click to expand...
It's not a case of hold dose for 6 cycles then increase. It has to be SAFE to increase. Also, holding a dose for only 6 cycles is for cats following tight regulation protocol; Vetsulin doses really need to be held for longer.


Mogs
.
 
Ozzy Pawzbourne said:
Do you think kitties can go into remission on vestulin? I read on one of your other posts- you posted some research from a Rand Roomp or something or other study and it mentioned remission is more likely on the tight regulation protocol. Remission is what we want if it's possible.
Click to expand...
Yes, some cats do achieve remission on Vetsulin.

Cats who start treatment with Lantus or Levemir within 6 months and who follow a programme of tight regulation have, according to the Roomp-Rand article, a significantly greater chance of achieving remission than those treated with shorter-acting insulins during the first 6 months following diagnosis. For cats who make the switch to a depot insulin later than six months the statistical likelihood of remission drops by about 50%.


Mogs
.
 
Critter Mom said:
Cats who start treatment with Lantus or Levemir within 6 months and who follow a programme of tight regulation have, according to the Roomp-Rand article, a significantly greater chance of achieving remission than those treated with shorter-acting insulins during the first 6 months following diagnosis. For cats who make the switch to a depot insulin later than six months the statistical likelihood of remission drops by about 50%.
Click to expand...
Shouldn't this be the exact reason we should ask the vet about switching? I don't know when would be a good time to switch though. I understand you when you have said it's all still new and Ozzy is still adjusting and healing.
 
Ozzy Pawzbourne said:
Remission is what we want if it's possible.
Click to expand...
As frustrating as it seems to you right now with the cup-shaped curves, Ozzy is actually responding well to his insulin treatment. It's early days and homeostatically speaking his body thinks those stinky pinks are normal. It takes time for the body to become accustomed to healthier numbers - and only Ozzy can set the pace for that.


Mogs
.
 
Ozzy Pawzbourne said:
Shouldn't this be the exact reason we should ask the vet about switching? I don't know when would be a good time to switch though. I understand you when you have said it's all still new and Ozzy is still adjusting and healing.
Click to expand...
Again I suggest that you keep things steady and stable for a little while to make sure Ozzy is fully recovered from his DKA episode. He is only a couple of weeks into treatment. The process of regulation can take months. As I said above, Ozzy is driving this; he's the lead in your sugar dance. :)

Perhaps it would be a good time now to discuss your treatment goals for Ozzy with your vet and perhaps work together to develop a treatment strategy which may, at some stage, include a switch to a depot insulin. If your vets aren't familiar with Lantus or Levemir they may want a little time to do some research on them. (Note: I have found that a goodly number of vets aren't as ambitious as we tend to be be here when it comes to treatment objectives: a lot of them consider getting a diabetic cat regulated well enough to keep it under the renal threshold and at minimal risk of hypoglycaemic episodes to be a roaring success ... )


Mogs
.
 
Thanks ladies. I actually didn't realize he was responding well. I thought because his numbers are still so high, that he wasn't doing good on it. I'm so new to all this, and all the information is so overwhelming. I'm so sorry for my zillion questions. I definitely don't want to rush the process or do anything to my kitty that is unsafe. Thanks for having patience with me, too. I'll get there, too. I promise.
 
Ozzy Pawzbourne said:
Lots of info on here....not all applies to my situation I now see.
Click to expand...
Hence the reason why we ask new members to add details of the insulin, meter, type of food, meds, medical history, dosing protocol/method being followed, etc., to enable other members to provide responses appropriate to each kitty's specific regimen. :)


Mogs
.
 
Critter Mom said:
Again I suggest that you keep things steady and stable for a little while to make sure Ozzy is fully recovered from his DKA episode. He is only a couple of weeks into treatment. The process of regulation can take months. As I said above, Ozzy is driving this; he's the lead in your sugar dance. :)
Click to expand...

Understood. I am going to keep him at the 1U and see how things go for a few weeks. Maybe he will be like Elmo and will just start regulating downwards over time.
 
Status
Not open for further replies.
Back
Top